Katz, Kenneth D, MD

Kurt, Anita, PhD, RN

Lonardi, Angeline

English

Lehigh Valley Health Network: LVHN Scholarly Works

Lehigh Valley Health NetworkLVHN Scholarly WorksResearch Scholars Poster PresentationEmergency Healthcare Provider Wait Time beforePatient Discharge after Opioid Administration: AGender AnalysisAngeline LonardiDeSales UniversityKenneth D. Katz MDLehigh Valley Health Network, Kenneth_D.Katz@lvhn.orgAnita Kurt PhD, RNLehigh Valley Health Network, Anita.Kurt@lvhn.orgFollow this and additional works at: http://scholarlyworks.lvhn.org/research-scholars-postersThis Poster is brought to you for free and open access by LVHN Scholarly Works. It has been accepted for inclusion in LVHN Scholarly Works by anauthorized administrator. For more information, please contact LibraryServices@lvhn.org.Published In/Presented AtLonardi, A., Katz, K., & Kurt, A. (2016, July, 29) Emergency Healthcare Provider Wait Time before Patient Discharge after OpioidAdministration: A Gender Analysis. Poster presented at LVHN Research Scholar Program Poster Session, Lehigh Valley HealthNetwork, Allentown, PA.© 2016 Lehigh Valley Health NetworkLehigh Valley Health Network, Allentown, PennsylvaniaEmergency Healthcare Provider Wait Time before Patient Discharge after Opioid Administration: A Gender AnalysisREFERENCES:1. Bertakis KD, Helms LJ, Callahan EJ, Azari R, Robbins JA. The Influence of Gender on Physician Practice Style. Med Care. 1995; 33(4):407-416.2. Chen, DC, Kirshenbaum DS, Yan J, Kirshenbaum E, Aseltine RH. Characterizing Changes in Student Empathy throughout Medical School. Med Teach. 2012; 34(4):305-311.3. Varney SM, Bebarta VS, Mannina LM, Ramos RG, Ganem VJ, Carey KR. Emergency Medicine Providers’ Opioid Prescribing Practices Stratified by Gender, Age, and Years in Practice. World J Emerg Med. 2016; 7(2):106-110.4. Kane J. Prescription Drug Abuse: Top 10 Things CDC Says You Should Know. PBS News Hour. 2013.5. Volkow, ND, McLellan TA. Characteristics of Opioid Prescriptions in 2009. JAMA.  2011; 305(13):1299-1301.6. Mazer-Amirshahi M, Mullins PM, Rasooly I, et al. Rising Opioid Prescribing in Adult US Emergency Department Visits: 2001–2010. Acad Emerg Med. 2014; 21:236-243.Emergency healthcare providers from the Lehigh Valley Health Network were sent a multiple-choice survey which asked each provider how long they wait to discharge a patient from the ER after the administration of different opioids.40 survey responses (28 female, 12 male) were analyzed.A Chi Squared test of independence was performed for each of the six questions with respect to provider gender.Female emergency healthcare providers reported waiting longer than male providers to discharge a patient after opioid administration for each of the six opioid treatments.  However, the gender disparities were not statistically significant for any of the six survey questions. Though this analysis failed to reject the null hypothesis, it calls for the exploration of the emergent pattern reported by the data. The experiment could be repeated with the following changes:Utilize a larger sample sizeInclude data from multiple institutionsPerform a more rigorous statistical analysisPast Studies Suggest that Female Medical Providers:Have longer appointments1May possess more empathy for patients2Focus on preventative care1Administer less opioids in the emergency department3While Male Providers:Devote more time to taking a medical history1Administer more opioids in the emergency department3This study found no statistically significant difference between the practices of male and female emergency healthcare providers. Further research must be done to determine if female emergency healthcare providers elect to keep patients in the emergency room significantly longer after opioid administration.Angeline Lonardi; Kenneth Katz, MD; Anita Kurt, PhD, RNGENDER DISPARITIESTHE “OPIOID EPIDEMIC”METHODS DISCUSSIONCONCLUSIONRESULTSForm Research Question Review Current LiteratureAdminister Survey by EmailCollect and Analyze DataDraw Conclusions010203040506031-60 61-120 >120 No TimeframePercent of Survey Responses (%)Wait Time before Discharge (minutes)Difference in Provider Wait Time before Patient Discharge after the Administration of Intravenous MorphineMaleFemaleResults of Statistical AnalysisQuestion Opioid of Interest P-Value1 Intramuscular Hydromorphone 0.74807272 Intravenous Hydromorphone 0.39762123 Intramuscular Morphine 0.92676464 Intravenous Morphine 0.37026785 Intravenous Fentanyl 0.72552886 Oral Opioids or Opiates 0.3895142The relationship between provider gender and time before discharge after opioid administration was not statistically significant (p < 0.05) for any of the analyzed opioids.Each of the six analyzed variables demonstrated a pattern similar to Intravenous Morphine; female providers showed a slight preference for a longer wait time.The number of nationwide deaths from prescription opioid overdose quadrupled between 1999 and 20104 Emergency healthcare providers prescribe about 25% of all opioid analgesics in the US5Between 2001 and 2010 there was a 49% increase in the percentage of emergency room patients that were prescribed an opioid6No official guidelines exist for the discharging of emergency department patients after opioid administrationPurpose: To determine if a significant difference exists between the amount of time male and female emergency healthcare providers wait to discharge patients who have received opioids.Hypothesis: Female emergency healthcare providers keep patients in the emergency room significantly longer after opioid administration than their male counterparts.Rationale: Female providers have been shown to spend more time with their patients and exhibit more caution when prescribing opioids in the emergency room. Therefore, they are more likely to wait longer to discharge a patient after the administration of opioids.ACKNOWLEDGEMENTS:This work was supported by the Dorothy Rider Pool Health Care Trust Research and Development grant and PCOM MedNET research grant.

Emergency Healthcare Provider Wait Time before Patient Discharge after Opioid Administration: A Gender Analysis

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Emergency Healthcare Provider Wait Time before Patient Discharge after Opioid Administration: A Gender Analysis

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